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Iron overload cardiomyopathy: from diagnosis to management

Díez-López, Carlesa; Comín-Colet, Josepb; González-Costello, Joséa

Current Opinion in Cardiology: May 2018 - Volume 33 - Issue 3 - p 334–340
doi: 10.1097/HCO.0000000000000511
CARDIAC FAILURE: Edited by Nir Uriel and Stavros Drakos

Purpose of review Iron overload cardiomyopathy (IOC) is an important predictor of prognosis in a significant number of patients with hereditary hemochromatosis and hematologic diseases. Its prevalence is increasing because of improved treatment strategies, which significantly improve life expectancy. We will review diagnosis, treatment, and recent findings in the field.

Recent findings The development of preclinical translational disease models during the last years have helped our understanding of specific disease pathophysiological pathways that might eventually change the outcomes of these patients.

Summary IOC is an overlooked disease because of the progressive silent disease pattern and the lack of physicians’ expertise. It mainly affects patients with hemochromatosis and hematologic diseases and its prevalence is expected to increase with the improvement in life expectancy of hematologic disorders. Early diagnosis of IOC in patients at risk by means of biochemical parameters and cardiac imaging can lead to early treatment and improved prognosis. The mainstay of treatment of IOC is conventional heart failure treatment, combined with phlebotomies or iron chelation in the context of anemia. The development of preclinical models has provided a comprehensive look into specific pathophysiological pathways with potential treatment strategies that must be sustained by future randomized trials.

aAdvanced Heart Failure and Transplant Unit

bCommunity Heart Failure Unit, IDIBELL, Heart Disease Institute, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain

Correspondence to José González-Costello, MD, Advanced Heart Failure and Transplant Unit, IDIBELL, Heart Disease Institute, Hospital Universitari de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain. Tel: +34932607931; e-mail: jgonzalez@bellvitgehospital.cat

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